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Patient Calls to Make an Appointment:
Patient Calls to Make an Appointment:
- If the patient states they have UHC but does not have their card:
- Use the UHC portal to verify what plan type they have.
(If you encounter any issues with the portal, please inform the managers)
(If you encounter any issues with the portal, please inform the managers)
- Patient Comes in for an Appointment Without a Card:
- Take the time to check the UHC portal to determine the type of plan they have.
PLEASE NOTE, NO REFERRAL, NO APPOINTMENT, unless they chose to do the following.
PLEASE NOTE, NO REFERRAL, NO APPOINTMENT, unless they chose to do the following.
- At check in, no referral, the patient can always sign an ABN and pay for the visit.
- Or chose to be self-pay 75% and sign the wavier.
Toya and Kathy work the Valley report, please reach out to them with any questions, they are more than willing to help.
Toya and Kathy work the Valley report, please reach out to them with any questions, they are more than willing to help.
Rocky Mountain Valley plan will be one plan under Rocky Mountain Valley starting 1.1.2025.
Rocky Mountain Valley plan will be one plan under Rocky Mountain Valley starting 1.1.2025.
The RMVP, also known as UnitedHealthcare Individual & Family ACA plan will be covering: Alamosa, Archuleta, Chaffee, Conejos, Costilla, Custer, Dolores, Eagle, Garfield, Grand, Gunnison, Hinsdale, Huerfano, La Plata, Lake, Mineral, Montezuma, Montrose, Ouray, Pitkin, Rio Grande, Routt, Saguache, San Juan, San Miguel and Summit
The RMVP, also known as UnitedHealthcare Individual & Family ACA plan will be covering: Alamosa, Archuleta, Chaffee, Conejos, Costilla, Custer, Dolores, Eagle, Garfield, Grand, Gunnison, Hinsdale, Huerfano, La Plata, Lake, Mineral, Montezuma, Montrose, Ouray, Pitkin, Rio Grande, Routt, Saguache, San Juan, San Miguel and Summit
Objective: This workflow addendum includes the steps unique to the UHC RMHP Valley plans to review for the Primary Care Provider’s referral in UHC’s online portal
Objective: This workflow addendum includes the steps unique to the UHC RMHP Valley plans to review for the Primary Care Provider’s referral in UHC’s online portal
Note: there is an alert set in eCW to notify you that a referral from the primary care physician must be completed in United Health Care's online portal for the orthopaedic visit to be approved
Note: there is an alert set in eCW to notify you that a referral from the primary care physician must be completed in United Health Care's online portal for the orthopaedic visit to be approved
Inform the patient of the unique requirement that a referral from their primary care physician must be completed in United Health Care's online portal for the orthopaedic visit to be approved. The PCP must be the PCP the patient has on record with UHC.
Inform the patient of the unique requirement that a referral from their primary care physician must be completed in United Health Care's online portal for the orthopaedic visit to be approved. The PCP must be the PCP the patient has on record with UHC.
Ask the patient if they have seen their PCP for this issue
Ask the patient if they have seen their PCP for this issue
If not, the visit will not be covered by UHC RMHP
If not, the visit will not be covered by UHC RMHP
o Guide the patient to schedule a visit with their PCP
o Guide the patient to schedule a visit with their PCP
o Or the patient may choose to schedule a self-pay visit with VSON
o Or the patient may choose to schedule a self-pay visit with VSON
If yes, ask if they were referred to VSON by their PCP
If yes, ask if they were referred to VSON by their PCP
If not, the visit will not be covered by UHC RMHP
If not, the visit will not be covered by UHC RMHP
o Guide the patient to contact their PCP to complete the referral
o Guide the patient to contact their PCP to complete the referral
o Or the patient may choose to schedule a self-pay visit with VSON
o Or the patient may choose to schedule a self-pay visit with VSON
If yes, log on to UHC’s portal at https://www.uhcprovider.com/ to verify that the PCP referral has been completed
If yes, log on to UHC’s portal at https://www.uhcprovider.com/ to verify that the PCP referral has been completed
Sign In (at the top right) and enter your One Healthcare ID and Password, then Sign In
Sign In (at the top right) and enter your One Healthcare ID and Password, then Sign In
Verify Eligibility & Benefits
Verify Eligibility & Benefits
o Enter the Member ID & Date of Birth
o Enter the Member ID & Date of Birth
Scroll to the ‘Policies’ section
Scroll to the ‘Policies’ section
o Confirm the policy is ‘Active’ and determine whether a referral is required (middle right of section)
o Confirm the policy is ‘Active’ and determine whether a referral is required (middle right of section)
o If ‘Yes, Required’ is indicated, select ‘Go To Referrals’
o If ‘Yes, Required’ is indicated, select ‘Go To Referrals’
Scroll to the ‘Patients Referrals History’ and determine if the appropriate referral is shown
Scroll to the ‘Patients Referrals History’ and determine if the appropriate referral is shown
If yes, then schedule the patients visit as normal
If yes, then schedule the patients visit as normal
If not, the visit will not be covered by UHC RMHP
If not, the visit will not be covered by UHC RMHP
o Guide the patient to contact their PCP to complete the referral
o Guide the patient to contact their PCP to complete the referral
o Or the patient may choose to schedule a self-pay visit with VSON
o Or the patient may choose to schedule a self-pay visit with VSON
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